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Biomedical subjects

P Voutilainen

Publications and source records attributed to P Voutilainen.

9 recordsLinked to original sources
PubMed1996

Femoral component fixation with and without intramedullary plug. A 6-year follow-up.

A total of 113 patients underwent a cemented total hip replacement (THR) operation involving femoral component fixation either without the use of a distal intramedullary plug (n = 57, group 1) or with the plug (n = 56, group 2). We studied the femoral component fixation radiographically at on average 6 years after THR. The cement coating was assessed as technically good in 86% and 95% of groups 1 and 2, respectively. There was radiographically diagnosable loosening of the femoral component at the follow-up in 25 cases in which stems were inserted without the intramedullary plug, and in 6 cases in those with the plug (P < 0.0008), and the mean subsidence of the femoral component was 5 mm in group 1 and 1.5 mm (P < 0.0003) in group 2, respectively. Osteolytic changes around the femoral component were noticed in both groups in equal numbers and with no statistical difference. The use of a distal intramedullary plug in the cementation of the femoral stem results in a better cement coating, reduces femoral component subsidence and ameliorates the loosening rates.

Aged↗
PubMed1996

Estimation of fetal shoulder width by measurement of the humerospinous distance by ultrasound.

The present study was undertaken to find a practical method for estimating the fetal shoulder width by ultrasound. Sixty pregnant women at term were included in the study. The distance between the lateral margin of the fetal cartilaginous caput humeri and the processus spinosus of the cervical vertebra C7 (humerospinous distance) was measured by ultrasound. The neonatal shoulder width was measured with a craniometer during the first postnatal day. Linear regression analysis was used to calculate the correlation between the humerospinous distance and the shoulder width, and a significant linear correlation (r = 0.612, p < 0.001) was shown. Although, in this small study, we could not show a relationship between humerospinous distance and dystocia, we feel a clinical study of humerospinous distance as a predictor of shoulder dystocia is indicated.

Adult↗
PubMed1995

Job enrichment, work motivation, and job satisfaction in hospital wards: testing the job characteristics model.

This study investigated work motivation and job satisfaction at hospital wards with high and low levels of job enrichment. Primary nursing was assumed to represent a highly enriched job, whereas functional nursing represented a job with a low level of enrichment. Five surgical wards were divided into these two categories based on the structured interviews with head nurses. Work motivation and job satisfaction among ward personnel were assessed by a questionnaire. The ward personnel occupying highly enriched jobs reported significantly higher work motivation and satisfaction with the management than the personnel occupying jobs with a low level of enrichment.

Adult↗
PubMed1993

[Quality assurance today and some future perspectives].

The purpose of this article is to describe the developmental level of QA in Finland. Working unit, regional and national level QA activities are reflected. The major effort to study the current situation of nursing QA was taken by STAKES (The National Research and Development Centre for Welfare and Health) in the beginning of 1993. Over 1200 institutions received a questionnaires where their QA activities were inquired. The increasing need for multiprofessional cooperation, better information and participation of nursing care personnel are discussed. To utilize research findings and to increase resources and skills of nursing care personnel to perform small scale studies are seen essential for QA advancement. To receive good quality care is a right of all patients. The nursing care personnel is responsible to deliver that kind of care. QA is a means to provide it. Accountability is demanded by both public and profession itself. Nurses have taken the leadership in providing good quality nursing care.

Clinical Competence↗
PubMed1992

[Assessment of construct and content validity of Monitor--an index of the quality of nursing care--and the evaluation of clarity and concreteness of the criteria of Monitor].

The purpose of this study was to test construct and content validity of Monitor and to evaluate if its criteria were clear and concrete. The construct validity was evaluated after reviewing the Finnish nursing literature in order to determine how man is perceived and what are the essential principles of Finnish nursing care. Each of the Monitor criteria was then compared with that view of man and the principles present in the literature. The human needs by Yura and Walsh were examined in order to find out to what extent the Monitor-instrument covers these needs. The content validity and the clarity and concreteness of the criteria were evaluated by experts. The results imply that the physical characteristics of man were prevalent in 76 out of 155 criteria. The essential principles were found in Monitor, but the principles concerning health centricity and patients' independence were found only in 13 out of 155 criteria. The instrument covered 4 human needs by Yura and Walsh totally and 20 in part. The experts rated 151 criteria content valid, 143 concrete and 139 clear in this study. Retesting is needed in the future studies.

Health Services Needs and Demand↗
PubMed1990

Direct relationship of antepartum glucose control and fetal erythropoietin in human type 1 (insulin-dependent) diabetic pregnancy.

In the present study the antepartum relationship between maternal diabetic glucose control and fetal hypoxaemia was examined in 44 Type 1 (insulin-dependent) diabetic and 23 non-diabetic control pregnancies. Maternal HbA1C was used to assess maternal integrated blood glucose control while fetal metabolic control was evaluated by antepartum glucose, insulin, and C-peptide determinations in amniotic fluid at elective caesarean delivery. Fetal hypoxaemia was assessed indirectly by fetal umbilical vein plasma erythropoietin level at delivery. A prospectively developed statistical pathway model was used to examine the relationship of these variables. In applying forced stepwise multiple regression with this model, we observed in the diabetic subjects that mean maternal HbA1C during the last month of pregnancy correlated significantly with fetal umbilical venous erythropoietin at delivery (r = 0.57, p less than 0.001). Additional significant contributions to umbilical venous erythropoietin were found for amniotic fluid glucose and amniotic fluid insulin when these two independent variables were added in stepwise fashion (p less than 0.01). We conclude that in diabetic pregnancy, antepartum control of maternal hyperglycaemia is a significant factor associated with fetal hypoxaemia. We speculate that this effect is mediated through perturbations which accelerate fetal metabolism and which is expressed by amniotic fluid levels of glucose and insulin.

Amniotic Fluid↗
PubMed1987

Amniotic fluid erythropoietin correlates with umbilical plasma erythropoietin in normal and abnormal pregnancy.

In the human fetus, elevated plasma erythropoietin levels have been found in high-risk pregnancies at delivery. We examined the relationship of amniotic fluid erythropoietin and umbilical plasma erythropoietin at delivery in 17 normal pregnancies, 41 hypertensive pregnancies, and 37 insulin-treated diabetic pregnancies terminated by elective cesarean section without labor. An additional 27 insulin-treated diabetic patients were studied after undergoing variable durations (86-1184 minutes) of labor. Erythropoietin was analyzed using a highly sensitive and specific radioimmunoassay technique. Fetal plasma erythropoietin concentrations were elevated above the control upper range (50.3 mU/mL) in 59% of the hypertensives and in 38% of the diabetics. The amniotic fluid erythropoietin values were significantly lower than the umbilical plasma erythropoietin values in each study group. Although the umbilical plasma erythropoietin values in the abnormal pregnancy groups differed considerably from the corresponding levels in the controls, the ratio of amniotic fluid erythropoietin to umbilical plasma erythropoietin was approximately the same in controls, hypertensives, and diabetics. Furthermore, the plasma and amniotic fluid levels (In transformed) correlated highly significantly in all three individual groups in absence of labor. In the diabetic labor group, this relationship was nonsignificant. We conclude that in the absence of labor, amniotic fluid erythropoietin reflects fetal plasma erythropoietin. We speculate that amniotic fluid erythropoietin may be an antepartum indicator of fetal hypoxemia.

Amniotic Fluid↗